{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T15:52:45Z","timestamp":1788882765430,"version":"build-2803163510"},"reference-count":25,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T00:00:00Z","timestamp":1741046400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"funder":[{"name":"Laboratory medical research project of Jiangsu Medical Association","award":["SYH-3201160-0067"],"award-info":[{"award-number":["SYH-3201160-0067"]}]},{"name":"Suzhou Gusu Health talent Research Project","award":["GSWS2021038"],"award-info":[{"award-number":["GSWS2021038"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>EDTA-dependent pseudothrombocytopenia (EDTA-PTCP) is an <jats:italic>in vitro<\/jats:italic> phenomenon that may lead to expensive, time-consuming, and invasive diagnostic procedures as well as unnecessary patient treatment. The purpose of this study was to explore the effects of time, anticoagulant and detection channel on the platelet (PLT) count of EDTA-PTCP samples, and to suggest a better method for correcting spurious low PLT counts.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>In this study, 43 identified EDTA-PTCP samples were collected. The Sysmex XN-9100, Mindray BC-6900 and Mindray BC-5390 haematology analysers were used to test these EDTA-PTCP samples on the following detection channels at different time points: PLT count by impedance method (PLT-I), PLT count by optical method (PLT-O) and PLT count by fluorescent staining (PLT-F).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>EDTA-PTCP was time-dependent and small PLT agglutination occurred in most of the corresponding citrate-treated samples. Our results further demonstrated that the detection channel significantly affected the PLT count of the EDTA-PTCP samples. The XN-9100 PLT-F channel exhibited a greater dissociative effect than the XN-9100 PLT-I and PLT-O channels. Moreover, blood samples processed in the PLT-O channel of the Mindray hematology analyzer showed the highest PLT count in EDTA-K2 tubes compared to the other detection channels.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Our data showed that time, anticoagulant and detection channel significantly affected the PLT count in the EDTA-PTCP samples. For the EDTA-PTCP samples, the simplest retest method was to use the PLT-O channel of the Mindray automatic blood analyser within 30 min. In addition, changing the sodium citrate anticoagulant and using the XN-9100 PLT-F channel within 15 min were also suitable for correcting the spurious low PLT of the EDTA-PTCP samples.<\/jats:p>\n<\/jats:sec>","DOI":"10.7717\/peerj.19103","type":"journal-article","created":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T08:48:37Z","timestamp":1741078117000},"page":"e19103","source":"Crossref","is-referenced-by-count":3,"title":["Effects of time, anticoagulant and detection channel on platelet count in ethylenediaminetetraacetic acid (EDTA)-dependent pseudothrombocytopenia"],"prefix":"10.7717","volume":"13","author":[{"given":"Yu","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bei","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, The Affiliated Suzhou Hospital of Nanjing University Medical School, Suzhou, Jiangsu Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaoying","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Luoyang maternal and child health care hospital, Luoyang, Henan Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meifen","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guanghua","family":"Zhai","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meina","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4443","published-online":{"date-parts":[[2025,3,4]]},"reference":[{"key":"10.7717\/peerj.19103\/ref-1","doi-asserted-by":"publisher","first-page":"65","DOI":"10.3904\/kjim.2002.17.1.65","article-title":"EDTA-dependent pseudothrombocytopenia confirmed by supplementation of kanamycin; a case report","volume":"17","author":"Ahn","year":"2002","journal-title":"The Korean Journal of Internal Medicine"},{"issue":"3","key":"10.7717\/peerj.19103\/ref-2","doi-asserted-by":"publisher","first-page":"808","DOI":"10.3390\/jcm9030808","article-title":"Platelet counting: ugly traps and good advice","volume":"9","author":"Baccini","year":"2020","journal-title":"Proposals from the French-Speaking Cellular Hematology Group (GFHC). Journal of Clinical Medicine"},{"key":"10.7717\/peerj.19103\/ref-3","doi-asserted-by":"publisher","first-page":"166","DOI":"10.21037\/tcr.2019.12.58","article-title":"Correction of spurious low platelet counts by optical fluorescence platelet counting of BC-6800 hematology analyzer in EDTA-dependent pseudo thrombocytopenia patients","volume":"9","author":"Bao","year":"2020","journal-title":"Translational Cancer Research"},{"key":"10.7717\/peerj.19103\/ref-4","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1002\/ajh.2830500206","article-title":"EDTA-dependent pseudothrombocytopenia: a clinical and epidemiological study of 112 cases, with 10-year follow-up","volume":"50","author":"Bizzaro","year":"1995","journal-title":"American Journal of Hematology"},{"key":"10.7717\/peerj.19103\/ref-5","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1159\/000452266","article-title":"Impact of amikacin on pseudothrombocytopenia","volume":"137","author":"Bokaei","year":"2017","journal-title":"Acta Haematologica"},{"key":"10.7717\/peerj.19103\/ref-6","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1136\/jcp.47.7.625","article-title":"EDTA dependent pseudothrombocytopenia caused by antibodies against the cytoadhesive receptor of platelet gpIIB-IIIA","volume":"47","author":"Casonato","year":"1994","journal-title":"Journal of Clinical Pathology"},{"issue":"2021","key":"10.7717\/peerj.19103\/ref-7","doi-asserted-by":"publisher","first-page":"3695407","DOI":"10.1155\/2021\/3695407","article-title":"Pseudothrombocytopenia inducing nonindicated platelet transfusion after cardiac surgery","volume":"2021","author":"Ceran","year":"2021","journal-title":"Case Reports in Medicine"},{"key":"10.7717\/peerj.19103\/ref-8","doi-asserted-by":"publisher","first-page":"1387","DOI":"10.1515\/cclm-2011-0892","article-title":"Novel method to dissociate platelet clumps in EDTA-dependent pseudothrombocytopenia based on the pathophysiological mechanism","volume":"50","author":"Chae","year":"2012","journal-title":"Clinical Chemistry and Laboratory Medicine"},{"key":"10.7717\/peerj.19103\/ref-9","doi-asserted-by":"publisher","first-page":"538","DOI":"10.1177\/1076029611430955","article-title":"The effects of aminoglycoside antibiotics on platelet aggregation and blood coagulation","volume":"18","author":"Chen","year":"2012","journal-title":"Clinical and Applied Thrombosis\/Hemostasis"},{"key":"10.7717\/peerj.19103\/ref-10","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1016\/S0049-3848(96)00229-0","article-title":"A novel approach to inhibit the anticoagulant-induced spontaneous activation of blood platelets--effect of magnesium on platelet release reaction in whole blood","volume":"85","author":"Gola\u0144ski","year":"1997","journal-title":"Thrombosis Research"},{"key":"10.7717\/peerj.19103\/ref-11","doi-asserted-by":"publisher","first-page":"1224","DOI":"10.3389\/fimmu.2019.02204","article-title":"The era of thromboinflammation: platelets are dynamic sensors and effector cells during infectious diseases","volume":"10","author":"Guo","year":"2019","journal-title":"Frontiers in Immunology"},{"key":"10.7717\/peerj.19103\/ref-12","doi-asserted-by":"publisher","first-page":"e28366","DOI":"10.7759\/cureus.28366","article-title":"Evaluation of platelet function using thromboelastography for a patient with pseudothrombocytopenia requiring cardiac reoperation","volume":"14","author":"Kometani","year":"2022","journal-title":"Cureus"},{"key":"10.7717\/peerj.19103\/ref-13","doi-asserted-by":"publisher","first-page":"594","DOI":"10.3390\/jcm10040594","article-title":"Pseudothrombocytopenia-a review on causes, occurrence and clinical implications","volume":"10","author":"Lardinois","year":"2021","journal-title":"Journal of Clinical Medicine"},{"key":"10.7717\/peerj.19103\/ref-14","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1002\/jcla.21818","article-title":"Discovery and correction of spurious low platelet counts due to EDTA-dependent Pseudothrombocytopenia","volume":"29","author":"Lin","year":"2014","journal-title":"Journal of Clinical Laboratory Analysis"},{"key":"10.7717\/peerj.19103\/ref-15","doi-asserted-by":"publisher","first-page":"1281","DOI":"10.1515\/cclm-2012-0081","article-title":"EDTA-dependent pseudothrombocytopenia: further insights and recommendations for prevention of a clinically threatening artifact","volume":"50","author":"Lippi","year":"2012","journal-title":"Clinical Chemistry and Laboratory Medicine"},{"key":"10.7717\/peerj.19103\/ref-16","doi-asserted-by":"publisher","first-page":"854","DOI":"10.1111\/ijlh.13920","article-title":"The diagnostic accuracy of Sysmex XN for identification of pseudothrombocytopenia using various thresholds for definition of platelet aggregation","volume":"44","author":"Lunde","year":"2022","journal-title":"International Journal of Laboratory Hematology"},{"issue":"3","key":"10.7717\/peerj.19103\/ref-17","doi-asserted-by":"publisher","first-page":"4780","DOI":"10.7754\/Clin.Lab.2023.230905","article-title":"Multianticoagulant pseudothrombocytopenia in a patient with primary carcinoma of the liver with hypersplenism","volume":"70","author":"Pang","year":"2024","journal-title":"Clinical Laboratory"},{"issue":"6","key":"10.7717\/peerj.19103\/ref-18","doi-asserted-by":"publisher","first-page":"1363","DOI":"10.1007\/s00277-023-05192-8","article-title":"Pseudothrombocytopenia, beyond a laboratory phenomenon: study of 192 cases","volume":"102","author":"Pujol-Moix","year":"2023","journal-title":"Annals of Hematology"},{"issue":"pt 1","key":"10.7717\/peerj.19103\/ref-19","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1042\/bj2760035","article-title":"Calcium binding to human platelet integrin GPIIb\/IIIa and to its constituent glycoproteins. Effects of lipids and temperature","volume":"276","author":"Rivas","year":"1991","journal-title":"Biochemical Journal"},{"key":"10.7717\/peerj.19103\/ref-20","doi-asserted-by":"publisher","first-page":"817","DOI":"10.1046\/j.1365-2141.1997.4773280.x","article-title":"Aminoglycosides prevent and dissociate the aggregation of platelets in patients with EDTA-dependent pseudothrombocytopenia","volume":"99","author":"Sakurai","year":"1997","journal-title":"British Journal of Haematology"},{"issue":"4","key":"10.7717\/peerj.19103\/ref-21","doi-asserted-by":"publisher","first-page":"544","DOI":"10.55519\/JAMC-04-12300","article-title":"Evaluation of sodium citrate anticoagulant for the resolution of edta-dependent pseudo Thrombocytopenia","volume":"35","author":"Sharif","year":"2023","journal-title":"Journal of Ayub Medical College Abbottabad"},{"key":"10.7717\/peerj.19103\/ref-22","doi-asserted-by":"publisher","first-page":"e38545","DOI":"10.7759\/cureus.38545","article-title":"Ethylene diamine tetra acetate-induced pseudo thrombocytopenia (EDTA-PTCP) in an adolescent: a case report","volume":"15","author":"Tangella","year":"2023","journal-title":"Cureus"},{"key":"10.7717\/peerj.19103\/ref-23","doi-asserted-by":"publisher","first-page":"e69","DOI":"10.1093\/labmed\/lmab090","article-title":"Kanamycin supplement for the disaggregation of platelet clumps in EDTA-dependent pseudothrombocytopenia specimens","volume":"53","author":"Tantanate","year":"2022","journal-title":"Laboratory Medicine"},{"issue":"1","key":"10.7717\/peerj.19103\/ref-24","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1007\/s00281-011-0286-4","article-title":"Platelets: versatile effector cells in hemostasis, inflammation, and the immune continuum","volume":"34","author":"Vieira-de-Abreu","year":"2012","journal-title":"Seminars in Immunopathology"},{"key":"10.7717\/peerj.19103\/ref-25","first-page":"569","article-title":"EDTA-dependent pseudothrombocytopenia\u2013differentiation from true thrombocytopenia","volume":"61","author":"Yoneyama","year":"2003","journal-title":"Nihon Rinsho"}],"container-title":["PeerJ"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/peerj.com\/articles\/19103.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/19103.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/19103.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/19103.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T08:48:45Z","timestamp":1741078125000},"score":1,"resource":{"primary":{"URL":"https:\/\/peerj.com\/articles\/19103"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,4]]},"references-count":25,"alternative-id":["10.7717\/peerj.19103"],"URL":"https:\/\/doi.org\/10.7717\/peerj.19103","archive":["CLOCKSS","LOCKSS","Portico"],"relation":{},"ISSN":["2167-8359"],"issn-type":[{"value":"2167-8359","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,4]]},"article-number":"e19103"}}